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General NPI Number Information
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NPI Number | 1962227058
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Entity Type | Organization
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Legal Business Name | SERENITY SPRINGS LIVING FACILITIES, INC
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1845 GARFIELD ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-3115
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Country | US
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Telephone | 954-921-1819
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Fax |
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Provider Business Mailing Address
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Address Line | 12555 ORANGE DR STE 4179
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City | DAVIE
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State | FL
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Zip | 33330-4304
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Country | US
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Telephone | 786-405-2708
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YANET LOPEZ
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Credential |
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Telephone | 786-405-2708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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